MICHAEL JOSEPH SIMMONS MD
NPI 1366554586
Otolaryngology in Jefferson City, MO

Q: What is Michael Simmons's NPI number?

The NPI number for Michael Simmons is 1366554586. It was assigned to this individual provider in the NPPES registry on September 1, 2006.

Q: What is Michael Simmons's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Michael Simmons was last updated on October 15, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 01, 2006PECOS EnrolledAccepts Medicare Assignment

1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109(573) 556-7708(573) 893-8061 Get Directions Write a Review

NPPES record last updated: October 15, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Michael Joseph Simmons Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL JOSEPH SIMMONS MD (NPI 1366554586) is an individual otolaryngology provider in Jefferson City, Missouri, licensed in Missouri (110060) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Ssm Health St Mary's Hospital Jefferson City, and is a graduate of Other (1990).

NPPES Registry Identity

NPI1366554586

Entity TypeIndividualMale

Primary Taxonomy207Y00000X

Provider Legal NameMICHAEL JOSEPH SIMMONSCredential: MD

Location Address1241 W STADIUM BLVDJefferson City, MO 65109-6023

Mailing AddressPo Box 104240Jefferson City, MO 65110-4240 · (573) 635-5264

Phone(573) 556-7708

Fax(573) 893-8061

Sole ProprietorNo

Medical School CMSOtherGraduated 1990

Enumeration DateSeptember 1, 2006

Last NPPES UpdateOctober 15, 2012

✔ NPI 1366554586 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

License✔ Licensed in MO · 110060

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

1241 W STADIUM BLVD, Jefferson City, MO 65109

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Other Identifiers 1

Medicare UPINF43010

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Michael Joseph Simmons Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3678507118

PECOS Enrollment IDI20100818000331

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 22

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Professional service for preparation and provision of 1 or more antigens 95165

This service involves the creation and supply of antigens, substances that stimulate your immune system to fight diseases. These antigens can be used in vaccines or allergy tests to help your body build defenses against specific health threats.

2,841 services71 patients

Professional service for single injection of allergen 95115

A single allergen injection is a procedure where a small amount of a specific allergen is injected into your body. This is done to test your body's reaction to the allergen or to help your immune system become less sensitive to it, reducing allergic symptoms.

445 services20 patients

Comprehensive hearing and speech recognition test 92557

A comprehensive hearing and speech recognition test assesses your ability to hear and understand spoken words. It includes hearing tests to check for issues with sound perception and speech tests to evaluate your word recognition. It's a crucial step in identifying any hearing or speech problems.

267 services263 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

247 services189 patients

Professional service for multiple injections of allergen 95117

The professional service for multiple injections of allergens involves administering small doses of specific allergens into your body. This is done to help your immune system become less sensitive to them, reducing your allergic reaction over time. It's a safe, effective way to manage allergies.

163 services12 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

138 services112 patients

Test for hearing various pitches using earphone 92552

This is a hearing test where earphones are worn to detect different pitch levels. Sounds of various frequencies are played, and you indicate when you hear them. This helps evaluate your hearing ability. It's safe, comfortable, and non-invasive.

125 services125 patients

Test for ability to detect and repeat spoken words with speech recognition 92556

This is a hearing test where you'll listen to spoken words through headphones and repeat them. It helps evaluate your ability to understand speech. It's a simple, non-invasive procedure that provides valuable information about your hearing health.

125 services125 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

117 services117 patients

Test to assess middle ear function 92567

A test to assess middle ear function, also known as an impedance audiometry, helps evaluate how well your middle ear works. It measures the movement of your eardrum in response to changes in air pressure. This can help identify issues like fluid build-up, ear infections, or eardrum perforations.

94 services91 patients

Diagnostic exam of voice box using a flexible endoscope 31575

This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.

74 services60 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

42 services42 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

40 services36 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

40 services38 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

37 services28 patients

Exam of ear using a microscope 92504

An exam of the ear using a microscope allows a detailed view of the ear structures. This non-invasive procedure helps identify issues such as infections, blockages, or ear damage. It's a safe, quick, and painless way to evaluate ear health.

36 services29 patients

Simple removal of skin debris and drainage of mastoid cavity 69220

This procedure involves clearing out skin debris and draining fluid from the mastoid cavity, an air-filled space in the skull behind the ear. It's done to relieve discomfort, improve hearing, and prevent complications related to ear infections or other conditions.

25 services14 patients

Pathology examination of tissue using a microscope, intermediate complexity 88305

A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.

23 services21 patients

Diagnostic exam of nasal passages using an endoscope 31231

A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.

22 services18 patients

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

22 services22 patients

Blood creatinine level 82565

A blood creatinine level test measures the amount of creatinine in your blood. Creatinine is a waste product that your body produces when it uses energy. High levels may indicate that your kidneys aren't working properly. This test is often used to monitor kidney health.

15 services15 patients

Urea nitrogen level to assess kidney function, quantitative 84520

The urea nitrogen level test is a routine blood test that checks the amount of urea nitrogen in your blood to evaluate how well your kidneys are working. If the levels are higher than normal, it may indicate that your kidneys are not functioning properly.

15 services15 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ssm Health St Mary's Hospital Jefferson City

Acute Care Hospitals · Jefferson City, MO

3/5 CMS rating

OwnershipProprietary

CMS Certification Number260011

Location2505 Mission DriveJefferson City, MO 65109 · Cole County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65109 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$121.96 typical visit price

range $52.28 – $161.24

Typical copayment $30.49 (range $13.07 – $40.31)

Most-billed visit code 99204

Established Patient

$65.71 typical visit price

range $16.30 – $131.05

Typical copayment $16.42 (range $4.07 – $32.76)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Appropriate Treatment for Children with Upper Respiratory Infection (URI)

Percentage of children 3 months-18 years of age who were diagnosed with upper respiratory infection (URI) and were not dispensed an antibiotic prescription on or three days after the episode

100%60 patients

Breast Cancer Screening

Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer

79%319 patients4/55-star benchmark: 92%

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

81%590 patients4/55-star benchmark: 85%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

100%1,516 patients5/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

88%286 patients3/55-star benchmark: 99%

Falls: Screening for Future Fall Risk

Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period

71%544 patients3/55-star benchmark: 99%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

100%296 patients5/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

60%660 patients3/55-star benchmark: 97%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

61%660 patients3/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

8%660 patients1/55-star benchmark: 89%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 0% · 544 patients

0%544 patients5/55-star benchmark: 100%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

5%660 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. THOMAS W. SCHNEIDER M.D.

Internal Medicine (Pulmonary Disease)